| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $19.07 | $19.07 | $19.07 | |
Aetna
| Professional | $16.96 | $19.07 | $22.68 | |
Molina
| Professional | $30.00 | $45.00 | $60.00 |
Re-Evaluation - Limited Problem Focused
| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $19.07 | $19.07 | $19.07 | |
Aetna
| Professional | $16.96 | $19.07 | $22.68 | |
Molina
| Professional | $30.00 | $45.00 | $60.00 |